Individual provider Active NPI

Enrique Creme Rivera

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1407642952
Registry record updated Apr 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11038946 Issued in FL
Practice address
6325 Commodore Dr
Jacksonville, FL 32244-3127
Phone
(786) 443-5846
NPI assigned
Apr 18, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11038946 FL Primary

Addresses

Primary practice location

6325 Commodore Dr
Jacksonville, FL 32244-3127

Mailing address

6325 Commodore Dr
Jacksonville, FL 32244-3127
Phone (786) 443-5846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11038946FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745020800000",
    "number": "1407642952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 COMMODORE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443127",
            "telephone_number": "786-443-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 COMMODORE DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322443127",
            "telephone_number": "786-443-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREME RIVERA",
        "first_name": "ENRIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-19",
        "certification_date": "2025-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11038946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.